Age at death of patients with colorectal cancer and the effect of lead-time bias on survival in elective vs emergency surgery

Abstract

Colorectal cancer is common in a population where actuarial life expectancy is limited. Current colorectal cancer early detection strategies may improve cancer-specific survival by increasing lead-time bias but do not influence overall life expectancy.

Survival outcome of patients with screening versus symptomatically detected colorectal cancers

“…The issue of lead time bias is also frequently raised with regard to screening and survival. There is an increase in apparent survival when the date of diagnosis is advanced irrespective of the date of death [14]. However, in this study, age at death is significantly higher in the screened group compared with the symptomatic group.…”

The 2‐week wait referral system does not improve 5‐year colorectal cancer survival

“…Such a study would require about 6000 patients in each arm to have a power of 80% in detecting a significant difference in survival. The slight increase in survival seen after the introduction of the 2WW system may have been the result of a lead‐time bias [5].…”

Temporal Trends in Long-Term Survival and Cure Rates in Esophageal Cancer: A SEER Database Analysis

“…1 Nevertheless, little is known if these patients are really cured of their malignant disease, or the reported, admittedly improved survival rates are just consequences of an institutional selection bias, changing epidemiology of esophageal carcinoma, or in cases of early cancer, products of lead time bias and a short follow-up. [2][3][4] To minimize these biases and assess national temporal trends in long-term survival and possible cure rates in patients with carcinoma of the esophagus and the gastric cardia, we analyzed Surveillance, Epidemiology, and End Results (SEER) cancer registry data, comparing cancerrelated survival in each stage through the last 3 decades in the United States.…”